Provider Demographics
NPI:1952193542
Name:MIKOLAJ, BENJAMIN R (DNP-PMHNP)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:R
Last Name:MIKOLAJ
Suffix:
Gender:M
Credentials:DNP-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7353 SISTERS GROVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923
Mailing Address - Country:US
Mailing Address - Phone:719-444-8484
Mailing Address - Fax:
Practice Address - Street 1:7353 SISTERS GROVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2615
Practice Address - Country:US
Practice Address - Phone:719-444-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0203768163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health